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Background: Pulmonary thromboembolism (PTE) remains under-diagnosed fatal disease at emergency units suggesting the need for alternative, easy, and noninvasive bedside diagnostic approaches. Objectives: To determine the diagnostic role of gray-scale and color Doppler transthoracic ultrasonography (TUS) in patients with PTE. Patients and Methods: Blinded to 64 multi-detectors CT pulmonary angiography (MDCTPA) examination as a gold standard, 60 patients with clinically suspected PTE underwent gray-scale and then color Doppler TUS examination. Results were compared and diagnostic accuracy of TUS was assessed. Results: Forty patients proved to have PTE by MDCTPA. TUS showed typical lesions in 33 patients with the mean of 2 lesions per patient. Most lesions were hypoechoic, wedge- shaped, and pleural- based and the majority (80%) was located in the lower lobes. Consolidation with little perfusion was detected by Color Doppler ultrasound in 97% of lesions. Isolated central PTE was significantly higher in TUS negative patients. For gray –scale TUS, sensitivity, specificity, positive and negative predictive values and accuracy were 82%, 90%, 94%, 72%, and 85%. Meanwhile the sensitivity, specificity, positive and negative predictive values and accuracy of color Doppler TUS were 80%, 95%, 97%, 70% and 87%, respectively. Conclusion: TUS is a reliable diagnostic bedside test for PTE in critically ill and immobile patients. Adding color Doppler to gray–scale TUS increases the specificity and accuracy and consequently the confidence in the diagnosis of peripheral pulmonary infarctions and differentiates them from other pulmonary lesions that allow initiation of anticoagulants.

Background: Pulmonary thromboembolism (PTE) remains under-diagnosed fatal disease at emergency units suggesting the need for alternative, easy, and noninvasive bedside diagnostic approaches. Objectives: To determine the diagnostic role of gray-scale and color Doppler transthoracic ultrasonography (TUS) in patients with PTE. Patients and Methods: Blinded to 64 multi-detectors CT pulmonary angiography (MDCTPA) examination as a gold standard, 60 patients with clinically suspected PTE underwent gray-scale and then color Doppler TUS examination. Results were compared and diagnostic accuracy of TUS was assessed. Results: Forty patients proved to have PTE by MDCTPA. TUS showed typical lesions in 33 patients with the mean of 2 lesions per patient. Most lesions were hypoechoic, wedge- shaped, and pleural- based and the majority (80%) was located in the lower lobes. Consolidation with little perfusion was detected by Color Doppler ultrasound in 97% of lesions. Isolated central PTE was significantly higher in TUS negative patients. For gray –scale TUS, sensitivity, specificity, positive and negative predictive values and accuracy were 82%, 90%, 94%, 72%, and 85%. Meanwhile the sensitivity, specificity, positive and negative predictive values and accuracy of color Doppler TUS were 80%, 95%, 97%, 70% and 87%, respectively. Conclusion: TUS is a reliable diagnostic bedside test for PTE in critically ill and immobile patients. Adding color Doppler to gray–scale TUS increases the specificity and accuracy and consequently the confidence in the diagnosis of peripheral pulmonary infarctions and differentiates them from other pulmonary lesions that allow initiation of anticoagulants.

Background: Pulmonary thromboembolism (PTE) remains under-diagnosed fatal disease at emergency units suggesting the need for alternative, easy, and noninvasive bedside diagnostic approaches. Objectives: To determine the diagnostic role of gray-scale and color Doppler transthoracic ultrasonography (TUS) in patients with PTE. Patients and Methods: Blinded to 64 multi-detectors CT pulmonary angiography (MDCTPA) examination as a gold standard, 60 patients with clinically suspected PTE underwent gray-scale and then color Doppler TUS examination. Results were compared and diagnostic accuracy of TUS was assessed. Results: Forty patients proved to have PTE by MDCTPA. TUS showed typical lesions in 33 patients with the mean of 2 lesions per patient. Most lesions were hypoechoic, wedge- shaped, and pleural- based and the majority (80%) was located in the lower lobes. Consolidation with little perfusion was detected by Color Doppler ultrasound in 97% of lesions. Isolated central PTE was significantly higher in TUS negative patients. For gray –scale TUS, sensitivity, specificity, positive and negative predictive values and accuracy were 82%, 90%, 94%, 72%, and 85%. Meanwhile the sensitivity, specificity, positive and negative predictive values and accuracy of color Doppler TUS were 80%, 95%, 97%, 70% and 87%, respectively. Conclusion: TUS is a reliable diagnostic bedside test for PTE in critically ill and immobile patients. Adding color Doppler to gray–scale TUS increases the specificity and accuracy and consequently the confidence in the diagnosis of peripheral pulmonary infarctions and differentiates them from other pulmonary lesions that allow initiation of anticoagulants.

Background: Pulmonary thromboembolism (PTE) remains under-diagnosed fatal disease at emergency units suggesting the need for alternative, easy, and noninvasive bedside diagnostic approaches. Objectives: To determine the diagnostic role of gray-scale and color Doppler transthoracic ultrasonography (TUS) in patients with PTE. Patients and Methods: Blinded to 64 multi-detectors CT pulmonary angiography (MDCTPA) examination as a gold standard, 60 patients with clinically suspected PTE underwent gray-scale and then color Doppler TUS examination. Results were compared and diagnostic accuracy of TUS was assessed. Results: Forty patients proved to have PTE by MDCTPA. TUS showed typical lesions in 33 patients with the mean of 2 lesions per patient. Most lesions were hypoechoic, wedge- shaped, and pleural- based and the majority (80%) was located in the lower lobes. Consolidation with little perfusion was detected by Color Doppler ultrasound in 97% of lesions. Isolated central PTE was significantly higher in TUS negative patients. For gray –scale TUS, sensitivity, specificity, positive and negative predictive values and accuracy were 82%, 90%, 94%, 72%, and 85%. Meanwhile the sensitivity, specificity, positive and negative predictive values and accuracy of color Doppler TUS were 80%, 95%, 97%, 70% and 87%, respectively. Conclusion: TUS is a reliable diagnostic bedside test for PTE in critically ill and immobile patients. Adding color Doppler to gray–scale TUS increases the specificity and accuracy and consequently the confidence in the diagnosis of peripheral pulmonary infarctions and differentiates them from other pulmonary lesions that allow initiation of anticoagulants.

Background: The effect of association between chronic obstructive pulmonary disease (COPD) and diabetes (DM) on platelet function has not been studied before. Objectives: To evaluate the effect of the association between COPD and DMon platelet function and C reactive protein (CRP). Patients and Methods: This case control study was carried out on 110 stable COPD patients who were classified into diabetic and nondiabetic groups. In addition, 40 apparently healthy, age and sex-matched individuals were included in this study as a control group. Chest X-ray, pulmonary function testing and arterial blood gases were done for COPD patients. CRP and complete blood count (CBC) were measured in both patient and control groups. Results: Mean platelet volume (MPV), platelet distribution width (PDW), platelet crit (PCT) and CRP were significantly higher in COPD patients either nondiabetic or diabetic compared to control group. Moreover, MPVand CRP markers were significantly higher in COPD diabetic patients compared to nondiabetic. There was no significant difference in various laboratory data among different stages of COPD either diabetic or nondiabetic (P>0.05). In COPD patients, MPV was a significantly positively correlated with CRP and PDW(r50.346, P0.001; r50.510, P0.001, respectively) and negatively correlated with PLT count (r520.294, P50.002). Conclusion: MPV, PDW, PCT and CRP were significantly higher in COPD patients either nondiabetic or diabetic. Platelet function may be modified by the systemic inflammation that associated with COPD. Platelet activation as a prothrombotic sequence of this disease may be used as novel therapeutic target. Please cite this paper as: Makhlouf HA, Sadek SH and Nafady AA. Platelet function in diabetic and nondiabetic patients with chronic obstructive pulmonary disease: a case control study. Clin Respir J 2016; 00: 000–000 DOI:10.1111/crj.12477.

Background: The effect of association between chronic obstructive pulmonary disease (COPD) and diabetes (DM) on platelet function has not been studied before. Objectives: To evaluate the effect of the association between COPD and DMon platelet function and C reactive protein (CRP). Patients and Methods: This case control study was carried out on 110 stable COPD patients who were classified into diabetic and nondiabetic groups. In addition, 40 apparently healthy, age and sex-matched individuals were included in this study as a control group. Chest X-ray, pulmonary function testing and arterial blood gases were done for COPD patients. CRP and complete blood count (CBC) were measured in both patient and control groups. Results: Mean platelet volume (MPV), platelet distribution width (PDW), platelet crit (PCT) and CRP were significantly higher in COPD patients either nondiabetic or diabetic compared to control group. Moreover, MPVand CRP markers were significantly higher in COPD diabetic patients compared to nondiabetic. There was no significant difference in various laboratory data among different stages of COPD either diabetic or nondiabetic (P>0.05). In COPD patients, MPV was a significantly positively correlated with CRP and PDW(r50.346, P0.001; r50.510, P0.001, respectively) and negatively correlated with PLT count (r520.294, P50.002). Conclusion: MPV, PDW, PCT and CRP were significantly higher in COPD patients either nondiabetic or diabetic. Platelet function may be modified by the systemic inflammation that associated with COPD. Platelet activation as a prothrombotic sequence of this disease may be used as novel therapeutic target. Please cite this paper as: Makhlouf HA, Sadek SH and Nafady AA. Platelet function in diabetic and nondiabetic patients with chronic obstructive pulmonary disease: a case control study. Clin Respir J 2016; 00: 000–000 DOI:10.1111/crj.12477.